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Antiparasitic Drug Use and Antiparasitic Resistance Survey

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Ruminant and Equine Antiparasitic Drug Use and $QWLSDUDVLWLFResistance Survey
Introduction

 

Welcome to the FDA Center for Veterinary Medicine Ruminant and Equine Antiparasitic Drug Use and $QWLSDUDVLWLFResistance Survey. We appreciate your  
SDUWLFLSDWLRQ,WLVimportant that your knowledge and experience are considered by the FDA as part of an overall strategy WRHQKDQFHWKHVXVWDLQDELOLW\DQGFRQWLQXHG
DYDLODELOLW\RIDSSURYHGYHWHULQDU\antiparasitic drugs. You were chosen to participate in the survey because of your membership in a veterinary professional 
RUJDQL]DWLRQZKLFKLQFOXGHVveterinarians, veterinary parasitologists, researchers, and others interested and involved with equine or food animal medicine and/or 
parasitology issues. 
 
The purpose of this survey is to gather information from members of the veterinary and veterinary parasitology community regarding antiparasitic drugs and the 
awareness of antiparasitic drug resistance. The survey will query subjects on topics including: (1) awareness of the issues related to antiparasitic drug 
resistance, (2) methods currently being used to detect and/or monitor for antiparasitic drug resistance, (3) management practices being used or recommended to 
manage or reduce antiparasitic drug resistance and (4) labeling and marketing considerations for antiparasitic drugs. FDA will share the results of the survey with 
 the public as part of its educational efforts. 

Please take a few minutes to answer the following questions by selecting the appropriate answer choice or entering the requested information, where applicable. 
You can advance through the pages of the questionnaire by clicking the "Next" button at the bottom of each page. We anticipate that the survey should take 
 about 30 minutes to complete. 
 If you have any questions about the survey, please contact Janis Messenheimer, DVM at (240) 276­8348 or [email protected]. 

OMB Approval: [to be added upon approval] 
 

Front Matter - 1

Survey Entry Question

 

*Your participation in this survey is strictly voluntary. You may answer as many or as few questions as you would like. However, your answers

will be most helpful if you answer all the questions. There are no known risks if you decide to participate in this survey, nor are there any costs
for participating in the survey. Your answers will be anonymous and confidential. Information will be kept confidential in accordance with 18 USC
1905 and 21 USC 331(j), as well as section 301(j) of the Federal Food Drug and Cosmetic Act. All responses will be reported as aggregated
responses.
You may exit from the survey and then come back to complete the survey at a later time. If you participate in the survey using a shared network
access (for example wireless network or shared computer), other individuals may not be able to participate in the survey and will need to use
another access point.
You may have received the link to this survey through another professional organization that you are a member of. Please complete the survey
only once.
By choosing yes below:
• you voluntarily agree to participate in the survey
• you attest that you are at least 18 years of age
• you attest that you have not previously completed this survey.
If you do not wish to participate in the survey, please decline participation by choosing 'No' to exit the survey. Please choose 'Yes' below if you
consent to taking the survey and are ready to begin.
 

j Yes Continue to Page 3
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j No
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n

End of Survey

 

Front Matter - 2

 

Education

Which one of the following options best describes your credentials?
j DVM
k
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n

 
 

j PhD or MS in Veterinary Parasitology
k
l
m
n
j Both
k
l
m
n

 
 

j Other (please specify)
k
l
m
n

 
Which one of the following options best describes your current employment type?
 

j Academia/ Research
k
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n

 

j Private practice
k
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n

j Government/ Regulatory
k
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n

 

 

j Industry
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n

 

j Retired/ Not actively employed
k
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n
j Student
k
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n

 

 

Front Matter - 3

Geographic Region

 

In which region of the world is your professional experience based? Select one of the options below.
 
j United States Continue to Page 5
k
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m
n
 
j United States and another region of the world Continue to Page 5
k
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n
 

j Region of the world other than the United States Continue to Exclusion,Page 62
k
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n

 

Front Matter - 4

United States

 

In which region of the United States is the majority of your professional experience based? Please choose one.
j Northwest­ WA, OR, ID
k
l
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n
j West ­ CA, NV
k
l
m
n

 

 

j Northern Rockies and Plains ­ MT, WY, ND, SD, NE
k
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n

 

 

j Southwest ­ UT, CO, AZ, NM
k
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n

j Upper Midwest ­ MN, WI, MI, IA
k
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n

 

j Ohio Valley ­ MO, IL, IN, OH, WV, KY, TN
k
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n
j South­ KS, OK, TX, AR, LA, MS
k
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n

 

 
 

j New England/ Mid­Atlantic ­ ME, NH, VT, NY, MA, RI, CT, NJ, DE, MD, PA
k
l
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n
j Southeast ­ VA, NC, SC, GA, AL, FL'
k
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n

 
 

j Hawaii, American Samoa, Guam, Northern Mariana Islands
k
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n
j Puerto Rico, U.S. Virgin Islands
k
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n
j Alaska
k
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n

 

 
 

j Other (please enter other region not listed or specify multiple regions if applicable.)
k
l
m
n

 

 
Continue to Page 7 if United States Only
Continue to Page 6 if United States and another region of the world

Front Matter - 5

World Region Outside of United States

 

In which region of the world other than the United States is your professional experience based? Select one or more of the options below.
 

c Africa
d
e
f
g
c Asia
d
e
f
g

 
 

c Australia/ New Zealand
d
e
f
g

 

c Canada
d
e
f
g

 

c Europe
d
e
f
g

c South America
d
e
f
g

 
 

c Other (please specify)
d
e
f
g

 

 

Front Matter - 6

Practice or Focus Area

 

Which one of the following best describes your current practice or focus area?
 

j Companion animal predominant or exclusive Continue to Exclusion, Page 62
k
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n

 

j Equine predominant or exclusive Continue to Page 9
k
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m
n

 

j Bovine predominant or exclusive
k
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n

Continue to Page 9
 

j Small ruminant predominant or exclusive Continue to Page 9
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m
n
j Mixed animal/ multiple animal species
k
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n

 

j Other (please specify)
k
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n

 

Continue to page 9

Continue to Page 8
 

 

Front Matter - 7

Experience

 

This survey is restricted to experiences in equine, bovine or small ruminant species. Do you have experience with any of the following: horses,
cattle, or small ruminants?
 

j Yes, I have experience with horses, cattle, or small ruminants.
k
l
m
n

Continue to Page 9
  Continue to Exclusion, Page 62

j No, I do not have any experience with horses, cattle, or small ruminants.
k
l
m
n

 

Front Matter - 8

Focus Area

 

What percentage of your practice, employment or research is devoted to the following groups of animals? Please fill in text boxes adjacent to the
animals that you have experience with.
Equine ­ Pleasure/ 
Performance
Equine ­ Racetrack
Beef Cattle
Dairy Cattle
Swine
Poultry
Sheep
Goats
Small Animal (cats/dogs)
Other (please specify species 
and percentage)

 

Front Matter - 9

General Questions on Antiparasitic Resistance

 

For the purposes of this survey, antiparasitic drug resistance is defined as the decreased effectiveness of an antiparasitic drug for parasite species
and stages for which it was previously effective. This may include a moderate decline in how well the drug works initially, a shorter duration of
efficacy requiring more frequent treatments, or a complete failure of the therapeutic regimen.
For each of the following species/ classes of animals, please indicate if you are aware of high, moderate, or low/ no prevalence of antiparasitic
drug resistance in the United States. If you do not have sufficient experience with a species or do not know whether or not there is resistance in a
species, please choose "unable to evaluate".
Aware of high 

Aware of moderate 

Aware of low/ no 

prevalence

prevalence

prevalence

Adult horses (3 years old and older)

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Young horses (less than 3 years old)

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Dairy cattle

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Cow­calf

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Background/stockers

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Feedlot cattle

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Sheep

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Goats

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Unable to evaluate

 

Front Matter - 10

General Questions on Antiparasitic Resistance

 

For the purposes of this survey, antiparasitic drug resistance is defined as the decreased effectiveness of an antiparasitic drug for parasite species
and stages for which it was previously effective. This may include a moderate decline in how well the drug works initially, a shorter duration of
efficacy requiring more frequent treatments, or a complete failure of the therapeutic regimen.
For each of the following species/ classes of animals, how would you characterize the level of risk for the development (or expansion) of
antiparasitic drug resistance in the United States? If you do not have sufficient experience or knowledge in a species to evaluate risk, please
choose "unable to evaluate".
High risk

Moderate risk

Low risk

Unable to evaluate

Adult horses (3 years old and older)

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Young horses (less than 3 years old)

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Dairy cattle

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Cow­calf

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Background/Stockers

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Feedlot cattle

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Sheep

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Goats

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

 

Front Matter - 11

General Questions on Antiparasitic Resistance

 

For the purposes of this survey, antiparasitic drug resistance is defined as the decreased effectiveness of an antiparasitic drug for parasite species
and stages for which it was previously effective. This may include a moderate decline in how well the drug works initially, a shorter duration of
efficacy requiring more frequent treatments, or a complete failure of the therapeutic regimen.
Have you experienced or witnessed antiparasitic drug resistance in horses, cattle or small ruminants in the United States in the past three years?
j Yes
k
l
m
n

 

Continue to Page 13

 

j No
k
l
m
n

 

j Uncertain
k
l
m
n

For No/ Uncertain answers:

 

If current focus area chosen was Mixed Animal/ Multiple animal species or Other - continue to Page 14
If current focus area chosen was Bovine pred./ excl. - continue to Page 15
If current focus area chosen was Equine pred./ excl. - continue to Page 29
If current focus area chosen was Small Ruminant pred./ excl. - continue to Page 43

Front Matter - 12

General Questions on Antiparasitic Resistance

 

Please list the antiparasitic drug resistance cases that you have experienced or witnessed in horses, cattle or small ruminants in the United States
within the past three years.
Choose one answer from each drop down menu for the target animal/drug/administration route/parasite of each example of parasite resistance
that you provide.
Target Animal/Class

Drug or drug class

Route of administration

Parasite

1

6

6

6

6

2

6

6

6

6

3

6

6

6

6

4

6

6

6

6

5

6

6

6

6

6

6

6

6

6

7

6

6

6

6

8

6

6

6

6

Other (please specify species, antiparasitic drug, route, and parasite) 
5

Target Animal: Adult horses(3 years old and older), Young horses(less than 3 years
old), Dairy Cattle, Cow/ Calf, Background/ stockers, Feedlot cattle, Sheep, Goats
Antiparasitic Drug: Fenbendazole, Multiple benzimidazoles, Oxfendazole, Albendazole,
Multiple macrocyclic lactones, Ivermectin, Eprinomectin, Moxidectin, Doramectin,
Pyrantel, Morantel, Levamisole, Piperazine, Other, Not determined

6 Route: Oral, Pour-on, Injection

 

Those
Those
Those
Those

who
who
who
who

chose
chose
chose
chose

Parasite: Large strongyles, Small strongyles (Cyathostomes), Parascaris equorum,
Oxyuris equi, Strongyloides, Ostertagia, Nematodirus, Cooperia, Haemonchus,
Teladorsagia, Trichostrongylus, Bunostomum, Ascaris, Oesophagostomum, Hyostrongylus,
Trichuris, Capillaria, Other, Not determined

Bovine Predominant/ Exclusive will continue to Page 15
Equine Predominant/ Exclusive will continue to Page 29
Small Ruminants Predominant/ Exclusive will continue to Page 43
Mixed Animal Practice/ Multiple animal species or Other will continue to Page 14

Front Matter - 13

Target animal selection

 

For the next portion of this survey, it will be helpful for FDA to know whether you are basing your answers on experience with horses, cattle or
small ruminants. Please choose the species/ target animal class that represents the animal you have the greatest experience or concern.
 

j Horses Continue to Page 28
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n
j Cattle
k
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m
n

 

Continue to Page 15
 

j Small ruminants Continue to Page 43
k
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m
n

 

j I do not have experience with horses, cattle or small ruminants
k
l
m
n

Continue to Exclusion,Page 62

 

Front Matter - 14

Treatment Decisions ­ Cattle

 

Are you involved in making any recommendations or treatment decisions regarding parasite treatment or control in cattle?
j Yes
k
l
m
n

  Continue to Page 16

 

Continue to Page 21

j No
k
l
m
n

 

Cattle - 15

Treatment Decisions ­ Cattle

 

What proportion of your clients involves you in decisions about parasite treatment and control?
j Less than 25%
k
l
m
n

 

j 25% to less than 50%
k
l
m
n
j 50% to less than 75%
k
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m
n

 
 

 

j 75% or more
k
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m
n

 

j This question does not apply to me
k
l
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n

 

Cattle - 16

Treatment Decisions ­ Cattle

 

There are many ways to determine which antiparasitic drug to use or recommend to treat an animal or group of animals. For cattle, which of the
following sources of information or methods do you use most often to determine which antiparasitic drug to use or recommend? Please select up
to three.
 

c Information from veterinary continuing education conferences
d
e
f
g

 

c Marketing and promotional materials for antiparasitic drugs
d
e
f
g

 

c Product label indications to determine if the drug is expected to work for the parasites I am attempting to treat
d
e
f
g

 

c Experience of other veterinarians in my practice or institution
d
e
f
g

 

c Use what I previously used for the animal(s) unless the animal owner gives information to suggest that the drug is not working anymore
d
e
f
g

 

c Peer­reviewed scientific journal articles
d
e
f
g

 

c Test the drug in the animal population and determine if it is effective based on an evaluation of fecal egg counts
d
e
f
g

 

Cattle - 17

Treatment Decisions ­ Cattle

 

In your professional experience, which of the following do you use or recommend most often to determine if an antiparasitic drug is effective in
cattle? Please select up to three.
 

c If there is no evidence of parasitism after treatment, conclude that the drug was effective
d
e
f
g

 

c Rely on the opinion of the farmer/producer/animal owner regarding the effectiveness of the antiparasitic drug
d
e
f
g

 

c Conduct a fecal analysis after treatment (without fecal egg count)
d
e
f
g
c Evaluate fecal egg counts pre­ or post­treatment
d
e
f
g

 
 

c Evaluate fecal egg counts pre­ and post­treatment (eg. Fecal Egg Count Reduction Test (FECRT))
d
e
f
g

 

c Make the determination based on resolution of clinical signs of parasitism (eg. ill­thrift, diarrhea, etc), if present at the time of treatment
d
e
f
g

 

c Use production data (milk production, weight gains, reproductive parameters) to determine if the drug is effective
d
e
f
g

 

Cattle - 18

Treatment Decisions ­ Cattle

 

If you determine an antiparasitic drug is not effective, what are your initial recommendations for the producer/ animal owner? Please rate up to
two choices that you do most often.
First choice

Second choice

Recommend animal management changes (cull animal(s), transfer to dry lot, quarantine, etc.)

j
k
l
m
n

j
k
l
m
n

Recommend pasture management changes (multispecies grazing, controlling forage height, rotational grazing, 

j
k
l
m
n

j
k
l
m
n

Start or continue fecal analysis as needed

j
k
l
m
n

j
k
l
m
n

Recommend treatment with another antiparasitic drug

j
k
l
m
n

j
k
l
m
n

Other (please specify in comment box below)

j
k
l
m
n

j
k
l
m
n

etc.)

Other option or comment 

 

Cattle-19

Treatment Decisions ­ Cattle

 

Please indicate the number of treatments per year that you recommend for routine deworming in cattle.
Number of treatments
6

Cattle less than 18 months of 
age

6

Cattle 18 months of age or 
older
Comment (if desired) 

Options for both age groups:
Less than one treatment per year
One treatment per year
More than one treatment per year
Not applicable - treatment depends on
fecal egg count or other
individualized treatment plan

Do you recommend rotating antiparasitic drugs for routine deworming in cattle?
Please choose from menu
6

Cattle less than 18 months of 
age

Options for both age groups:
Yes, I recommend rotation
No, I do not recommend rotation

6

Cattle 18 months of age or 
older
Other (please specify) 

Do you use or recommend the use of two or more antiparasitic drugs at the same time in individual animals?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

If yes, please list the drugs you use together in cattle. 
5
6

 

Cattle - 20

Detection and Management of Resistance ­ Cattle

 

Do you perform or recommend fecal examination procedures to detect and/or quantify parasite eggs in cattle?
j Yes
k
l
m
n

  Continue to Page 22

 

Continue to Page 26

j No
k
l
m
n

 

Cattle - 21

Detection and Management of Resistance ­ Cattle

 

Please select the options below that best describe the fecal examination procedures you use or recommend to detect and/or quantify fecal eggs
in cattle.
Fecal Float Solution

Method/technique

1

6

6

2

6

6

3

6

6

4

6

6

5

6

6

Other (explanation if "other" selected above) 
5

6

 
Solution choices: None-direct or saline smear, Zinc sulfate, Sheathers, Modified sheathers,
Magnesium sulfate, Saturated salt, Sodium nitrate, Sugar-salt, Other, Unknown, Not sure what my lab uses
Method/technique choices: Direct smear, Saline smear, Simple flotation, Sedimentation,
Centrifugation, McMasters, Modified McMasters, Wisconsin, Modified Wisconsin, FLOTAC, Other,Unknown,
Not sure what my lab uses

Cattle - 22

Detection and Management of Resistance ­ Cattle

 

Do you use larval cultures to identify parasite species in cattle?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

j I am not familiar with the use of larval culture
k
l
m
n

 

Do you use or recommend the fecal egg count reduction test (FECRT) to determine treatment efficacy in cattle that are treated with an
antiparasitic drug?
 

j Yes Continue to Page 24
k
l
m
n

 

j No
k
l
m
n

Continue to Page 26
 

j I am not familiar with the FECRT Continue to Page 26
k
l
m
n

 

Cattle - 23

Detection and Management of Resistance ­ Cattle

 

Which one of the following statements best represents the method you use or recommend to determine fecal egg count reduction in cattle?
 

j FECRT based on a comparison of pre­ and post­ treatment fecal egg counts of a treated group/animal
k
l
m
n

 

j FECRT based on a comparison of post­treatment fecal egg counts of a treated and an untreated­control group/animal
k
l
m
n

 

j FECRT includes pre­ and post­treatment fecal egg counts from both a treated and an untreated­control group/animal
k
l
m
n

Other (please specify) 
5
6

Which one of the following best represents the type of samples you use or recommend to conduct the fecal egg count reduction test (FECRT)?
 

j Composite fecal sample (fecal samples from individual animals mixed together)
k
l
m
n

 

j Fecal samples from individual animals
k
l
m
n

 

Cattle 24

Detection and Management of Resistance ­ Cattle

 

What is the FECRT calculation cut­off value you use or recommend to determine if treatment with an antiparasitic drug is effective?
 

j Greater than or equal to 80%
k
l
m
n

 

j Greater than or equal to 85%
k
l
m
n

 

j Greater than or equal to 90%
k
l
m
n

 

j Greater than or equal to 95%
k
l
m
n

 

j Greater than or equal to a previous FECRT result
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Cattle - 25

Detection and Management of Resistance ­ Cattle

 

Which of the following management practices do you most often implement or recommend for a parasite control program in cattle? Please select
up to three choices.
c Maintain a portion of the worm population that is not exposed to the antLSDUDVLWLFGUXJ and can go on to establish in a host (refugia)
d
e
f
g

 

 

c Implementation of quarantine procedures
d
e
f
g

 

c Pasture management­ multispecies grazing, controlling forage height, rotational grazing, etc.
d
e
f
g
c Selection for parasite resistant animals
d
e
f
g

 
 

c Alternative techniques (copper wire particles or fungi, etc)
d
e
f
g

 

c Age specific treatment recommendations (for example, minimizing treatment of adult animals)
d
e
f
g

 

c Use of two or more antiparasitic drugs at the same time in individual animals
d
e
f
g

 

c Strategic deworming (treating when majority of parasites are in the animal and not in the environment)
d
e
f
g

 

c I have not implemented or recommended any management practices for parasite control
d
e
f
g
c 2WKHUSOHDVHVSHFLI\
d
e
f
g

 

 

Cattle - 26

Detection and Management of Resistance ­ Cattle

 

Have you changed the management practices you implement or recommend for parasite control in cattle in response to antiparasitic drug
resistance? Please choose one answer.
 

j No, because I have not experienced any resistance
k
l
m
n

 

j No, because changes have not been necessary
k
l
m
n

j Yes, in response to information about resistance
k
l
m
n

 
 

j Yes, in response to resistance that I have experienced
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Cattle - 27

Continue survey

 

If you would like to repeat the Treatment Decisions and Detection and Management of Resistance portions of the survey for a different animal
species or class, please choose one of the options below. Otherwise to continue to the final portion of the survey, please choose 'Continue with
survey'.
 

j Horses Continue to Page 29
k
l
m
n
j Small ruminants
k
l
m
n

  Continue to Page 43

j Continue with survey
k
l
m
n

 

Continue to Page 58

 

Cattle - 28

Treatment Decisions ­ Horses

 

Are you involved in making any recommendations or treatment decisions regarding parasite treatment or control in horses?
j Yes
k
l
m
n

  Continue to Page 30

 

Continue to Page 35

j No
k
l
m
n

 

Horses - 29

Treatment Decisions ­ Horses

 

What proportion of your clients involves you in decisions about parasite treatment and control?
j Less than 25%
k
l
m
n

 

j 25% to less than 50%
k
l
m
n
j 50% to less than 75%
k
l
m
n

 
 

 

j 75% or more
k
l
m
n

 

j This question does not apply to me
k
l
m
n

 

Horses - 30

Treatment Decisions ­ Horses

 

There are many ways to determine which antiparasitic drug to use or recommend to treat an animal or group of animals. In horses, which of the
following sources of information or methods do you use most often to determine which antiparasitic drug to use or recommend in horses? Please
select up to three.
 

c Information from veterinary continuing education conferences
d
e
f
g

 

c Marketing and promotional materials for antiparasitic drugs
d
e
f
g

 

c Product label indications to determine if the drug is expected to work for the parasites I am attempting to treat
d
e
f
g

 

c Experience of other veterinarians in my practice or institution
d
e
f
g

 

c Use what I previously used for the animal(s) unless the animal owner gives information to suggest that the drug is not working anymore
d
e
f
g

 

c Peer­reviewed scientific journal articles
d
e
f
g

 

c Test the drug in the animal population and determine if it is effective based on an evaluation of fecal egg counts
d
e
f
g

 

Horses - 31

Treatment Decisions ­ Horses

 

In your professional experience, which of the following do you use or recommend most often to determine if an antiparasitic drug is effective in
horses? Please select up to three.
 

c If there is no evidence of parasitism after treatment, conclude that the drug was effective
d
e
f
g

 

c Rely on the opinion of the farmer/producer/animal owner regarding the effectiveness of the antiparasitic drug
d
e
f
g

 

c Conduct a fecal analysis after treatment (without fecal egg count)
d
e
f
g
c Evaluate fecal egg counts pre­ or post­treatment
d
e
f
g

 
 

c Evaluate fecal egg counts pre­ and post­treatment (eg. Fecal Egg Count Reduction Test (FECRT))
d
e
f
g

 

c Make the determination based on resolution of clinical signs of parasitism (eg. ill­thrift, diarrhea, etc), if present at the time of treatment
d
e
f
g

 

Horses - 32

Treatment Decisions ­ Horses

 

If you determine an antiparasitic drug is not effective, what are your initial recommendations for the animal owner? Please rate up to two choices
that you do most often.
First choice

Second choice

Recommend animal management changes (segregation by age, minimization of horses per acre, etc.)

j
k
l
m
n

j
k
l
m
n

Recommend pasture management changes (regular removal of manure, composting, routine mowing and 

j
k
l
m
n

j
k
l
m
n

Change to a selective treatment program in which treatments are given based on level of fecal egg counts.

j
k
l
m
n

j
k
l
m
n

Start or continue fecal analysis as needed

j
k
l
m
n

j
k
l
m
n

Recommend treatment with another antiparasitic drug

j
k
l
m
n

j
k
l
m
n

Other (please specify in comment box below)

j
k
l
m
n

j
k
l
m
n

harrowing of pasture, etc.)

Other option or comment 

 

Horses-33

Treatment Decisions ­ Horses

 

Please indicate the number of treatments per year that you recommend for routine deworming in
horses.
Frequency of treatments

Horses less than WKUHH yearV of age

6

Horses WKUHH yearV of age or older

6

Comment (if desired) 

How frequently do you rotate or recommend an animal owner rotate antiparasitic drugs for routine
deworming in horses?

Horses less than WKUHH yearV of age

6

Horses WKUHH yearV of age or older

6

Options for both age groups:
One to two treatments per year
Three to four treatments per year
Five to six treatments per year
Seven or more treatments per year
Not applicable/treatment depends on
fecal egg count or other
individualized treatment plan

Options for both age groups:
Multiple times per year
Yearly
Less frequently than yearly
Never

Comment (if desired) 

Do you use or recommend the use of two or more antiparasitic drugs at the same time in individual horses?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

If yes, please list the drugs you use together in horses. 
5
6

 

Horses - 34

Detection and Management of Resistance ­ Horses

 

Do you perform or recommend fecal examination procedures to detect and/or quantify parasite eggs in horses?
j Yes
k
l
m
n

 

j No
k
l
m
n

 

Continue to Page 36
Continue to Page 40

 

Horses - 35

Detection and Management of Resistance ­ Horses

 

Please select the options below that best describe the fecal examination procedures you use or recommend to detect and/or quantify fecal eggs
in horses?
Fecal Float Solution

Method/technique

1

6

6

2

6

6

3

6

6

4

6

6

5

6

6

Other (explanation if "other" selected above) 
5

6

Solution choices: None-direct or saline smear,  Zinc sulfate, Sheathers, Modified sheathers,
Magnesium sulfate, Saturated salt, Sodium nitrate, Sugar-salt, Other, Unknown, Not sure what my lab uses
Method/technique choices: Direct smear, Saline smear, Simple flotation, Sedimentation,
Centrifugation, McMasters, Modified McMasters, Wisconsin, Modified Wisconsin, FLOTAC, Other,Unknown,
Not sure what my lab uses

Horses - 36

Detection and Management of Resistance ­ Horses

 

Do you use larval cultures to identify parasite species in horses?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

j I am not familiar with the use of larval culture
k
l
m
n

 

Do you use or recommend the fecal egg count reduction test (FECRT) to determine treatment efficacy in horses that are treated with an
antiparasitic drug?
j Yes
k
l
m
n

  Continue to Page 38

 

Continue to Page 40

j No
k
l
m
n

 
j I am not familiar with the FECRT Continue to Page 40
k
l
m
n

 

Horses - 37

Detection and Management of Resistance ­ Horses

 

Which one of the following statements best represents the method you use or recommend to determine fecal egg count reduction in horses?
 

j FECRT based on a comparison of pre­ and post­ treatment fecal egg counts of a treated group/animal
k
l
m
n

 

j FECRT based on a comparison of post­treatment fecal egg counts of a treated and an untreated­control group/animal
k
l
m
n

 

j FECRT includes pre­ and post­treatment fecal egg counts from both a treated and an untreated­control group/animal
k
l
m
n

Other (please specify) 
5
6

Which one of the following best represents the type of samples you use or recommend to conduct the fecal egg count reduction test (FECRT)?
 

j Composite fecal sample (fecal samples from individual animals mixed together)
k
l
m
n

 

j Fecal samples from individual animals
k
l
m
n

 

Horses-38

Detection and Management of Resistance ­ Horses

 

What is the FECRT calculation cut­off value you use or recommend to determine if treatment with an antiparasitic drug is effective?
 

j Greater than or equal to 80%
k
l
m
n

 

j Greater than or equal to 85%
k
l
m
n

 

j Greater than or equal to 90%
k
l
m
n

 

j Greater than or equal to 95%
k
l
m
n

 

j Greater than or equal to a previous FECRT result
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Horses - 39

Detection and Management of Resistance ­ Horses

 

Which of the following management practices do you most often implement or recommend for a parasite control program in horses? Please
select up to three choices.
c Maintain a portion of the worm population that is not exposed to the antLSDUDVLWLFGUXJ and can go on to establish in a host (refugia)
d
e
f
g

 

 

c Implementation of quarantine procedures
d
e
f
g

 

c Pasture management­ multispecies grazing, controlling forage height, rotational grazing, etc.
d
e
f
g

 

c Age specific treatment recommendations (for example, minimizing treatment of adult animals)
d
e
f
g

 

c Use of two or more antiparasitic drugs at the same time in individual animals
d
e
f
g

 

c Strategic deworming (treating when majority of parasites are in the animal and not in the environment)
d
e
f
g

 

c I have not implemented or recommended any management practices for parasite control
d
e
f
g

Other (please specify)

 

Horses - 40

Detection and Management of Resistance ­ Horses

 

Have you changed the management practices you implement or recommend for parasite control in horses in response to antiparasitic drug
resistance? Please choose one answer.
 

j No, because I have not experienced any resistance
k
l
m
n

 

j No, because changes have not been necessary
k
l
m
n

j Yes, in response to information about resistance
k
l
m
n

 
 

j Yes, in response to resistance that I have experienced
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Horses - 41

Continue Survey

 

If you would like to repeat the Treatment Decisions and Detection and Management of Resistance portions of the survey for a different animal
species or class, please choose one of the options below. Otherwise to continue to the final portion of the survey, please choose 'Continue with
survey'.
 
j Cattle Continue to Page 15
k
l
m
n
j Small ruminants
k
l
m
n

  Continue to Page 43

j Continue with survey
k
l
m
n

  Continue to Page 58

 

Horses - 42

Treatment Decisions ­ Small Ruminants

 

Are you involved in making any recommendations or treatment decisions regarding parasite treatment or control in small ruminants?
j Yes
k
l
m
n

 

j No
k
l
m
n

 

Continue to Page 44
Continue to Page 49

 

Small Ruminants - 43

Treatment Decisions ­ Small Ruminants

 

What proportion of your clients involves you in decisions about parasite treatment and control?
j Less than 25%
k
l
m
n

 

j 25% to less than 50%
k
l
m
n
j 50% to less than 75%
k
l
m
n

 
 

 

j 75% or more
k
l
m
n

 

j This question does not apply to me
k
l
m
n

 

Small Ruminants - 44

Treatment Decisions ­ Small Ruminants

 

There are many ways to determine which antiparasitic drug to use or recommend to treat an animal or group of animals. Which of the following
sources of information or methods do you use most often to determine which antiparasitic drug to use or recommend? Please select up to three.
 

c Information from veterinary continuing education conferences
d
e
f
g

 

c Marketing and promotional materials for antiparasitic drugs
d
e
f
g

 

c Product label indications to determine if the drug is expected to work for the parasites I am attempting to treat
d
e
f
g

 

c Experience of other veterinarians in my practice or institution
d
e
f
g

 

c Use what I previously used for the animal(s) unless the animal owner gives information to suggest that the drug is not working anymore
d
e
f
g

 

c Peer­reviewed scientific journal articles
d
e
f
g

 

c Test the drug in the animal population and determine if it is effective based on an evaluation of fecal egg counts
d
e
f
g

 

Small Ruminants - 45

Treatment Decisions ­ Small Ruminants

 

In your professional experience, which of the following do you use or recommend most often to determine if an antiparasitic drug is effective in
small ruminants? Please select up to three.
 

c If there is no evidence of parasitism after treatment, conclude that the drug was effective
d
e
f
g

 

c Rely on the opinion of the farmer/producer/animal owner regarding the effectiveness of the antiparasitic drug
d
e
f
g

 

c Conduct a fecal analysis after treatment (without fecal egg count)
d
e
f
g
c Evaluate fecal egg counts pre­ or post­treatment
d
e
f
g

 
 

c Evaluate fecal egg counts pre­ and post­treatment (eg. Fecal Egg Count Reduction Test, FECRT)
d
e
f
g

c Make the determination based on resolution of clinical signs of parasitism (eg. FAMACHA system for H. contortus, ill­thrift, diarrhea, etc), if present at 
d
e
f
g

the time of treatment 
 

c Use production data (milk production, weight gains, reproductive parameters) to determine if the drug is effective
d
e
f
g

 

Small Ruminants - 46

Treatment Decisions ­ Small Ruminants

 

If you determine an antiparasitic drug is not effective, what are your initial recommendations for the producer/ animal owner? Please rate up to
two choices that you do most often.
First choice

Second choice

Recommend animal management changes (cull animals, quarantine, implement FAMACHA, etc.)

j
k
l
m
n

j
k
l
m
n

Recommend pasture management changes (multispecies grazing, controlling forage height, rotational grazing, 

j
k
l
m
n

j
k
l
m
n

Start or continue fecal analysis as needed

j
k
l
m
n

j
k
l
m
n

Recommend treatment with another antiparasitic drug

j
k
l
m
n

j
k
l
m
n

Other (please specify in comment box below)

j
k
l
m
n

j
k
l
m
n

etc.)

Other option or comment 

 

Small Ruminants-47

Treatment Decisions ­ Small Ruminants

 

Please indicate the number of treatments per year that you recommend for routine deworming in small ruminants.
Number of treatments
Sheep or goats less than one year of age

6

Sheep or goats one year of age or older

6

Other (please specify) 

Options for both age groups:
Less than one treatment per year
One treatment per year
Two treatments per year
Three or more treatments per year
Not applicable - treatment depends
on fecal egg count, FAMACHA,
or other individualized
treatment plan

How frequently do you rotate or recommend that an animal owner rotate antiparasitic drugs for routine deworming in small ruminants?
Frequency of rotation Options for both age groups:
Sheep or goats less than one year of age

6

Sheep or goats one year of age or older

6

Other (please specify) 

Multiple times per year
Yearly
Less frequently than yearly
Never

Do you use or recommend the use of two or more antiparasitic drugs at the same time in individual animals?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

If yes, please list the drugs you use together in small ruminants. 
5
6

 

Small Ruminants - 48

Detection and Management of Resistance ­ Small Ruminants

 

Do you perform or recommend fecal examination procedures to detect and/or quantify parasite eggs in small ruminants?
j Yes
k
l
m
n

  Continue to Page 50

 

Continue to Page 55

j No
k
l
m
n

 

Small Ruminants - 49

Detection and Management of Resistance ­ Small Ruminants

 

Please select the options below that best describe the fecal examination procedures you use or recommend to detect and/or quantify fecal eggs
in small ruminants. You may fill out more than one method per target animal.
Fecal Float Solution

Method/technique

1

6

6

2

6

6

3

6

6

4

6

6

5

6

6

Other (explanation if "other" selected above) 
5

6

 
Solution choices: None-direct or saline smear, Zinc sulfate,
Sheathers, Modified sheathers,
Magnesium sulfate, Saturated salt, Sodium nitrate, Sugar-salt, Other, Unknown, Not sure what my lab uses
Method/technique choices: Direct smear, Saline smear, Simple flotation, Sedimentation,
Centrifugation, McMasters, Modified McMasters, Wisconsin, Modified Wisconsin, FLOTAC, Other,Unknown,
Not sure what my lab uses

Small Ruminants - 50

Detection and Management of Resistance ­ Small Ruminants

 

Do you use larval cultures to identify parasite species in small ruminants?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

j I am not familiar with the use of larval culture
k
l
m
n

 

Do you use or recommend the fecal egg count reduction test (FECRT) to determine treatment efficacy in small ruminants that are treated with an
antiparasitic drug?
j Yes
k
l
m
n

 

j No
k
l
m
n

 

Continue to Page 52
Continue to Page 54
 

j I am not familiar with the FECRT
k
l
m
n

Continue to Page 54

 

Small Ruminants - 51

Detection and Management of Resistance ­ Small Ruminants

 

Which one of the following statements best represents the method you use or recommend to determine fecal egg count reduction?
 

j FECRT based on a comparison of pre­ and post­ treatment fecal egg counts of a treated group/animal
k
l
m
n

 

j FECRT based on a comparison of post­treatment fecal egg counts of a treated and an untreated­control group/animal
k
l
m
n

 

j FECRT includes pre­ and post­treatment fecal egg counts from both a treated and an untreated­control group/animal
k
l
m
n

Other (please specify) 
5
6

Which one of the following best represents the type of samples you use or recommend to conduct the fecal egg count reduction test (FECRT)?
 

j Composite fecal sample (fecal samples from individual animals mixed together)
k
l
m
n

 

j Fecal samples from individual animals
k
l
m
n

 

Small Ruminants -52

Detection and Management of Resistance ­ Small Ruminants

 

What is the FECRT calculation cut­off value you use or recommend to determine if treatment with an antiparasitic drug is effective?
 

j Greater than or equal to 80%
k
l
m
n

 

j Greater than or equal to 85%
k
l
m
n

 

j Greater than or equal to 90%
k
l
m
n

 

j Greater than or equal to 95%
k
l
m
n

 

j Greater than or equal to a previous FECRT result
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Small Ruminants - 53

Ruminant and Equine Antiparasitic Drug Use and Antiparasitic Resistance Survey
Detection and Management of Resistance ­ Small Ruminants

 

Other methods to detect or monitor antiparasitic drug resistance include egg hatching, larval migration test, larval development assay, worm
counts, molecular based tests, etc.
Do you use tests/methods other than the fecal egg count reduction test to detect or monitor antiparasitic drug resistance?
j Yes
k
l
m
n
j No
k
l
m
n

 

 

If, yes, please list the tests you use 
5
6

 

Small Ruminants-54

Detection and Management of Resistance ­ Small Ruminants

 

Which of the following management practices do you most often implement or recommend for a parasite control program in small ruminants?
Please select up to three choices.
c Maintain a portion of the worm population that is not exposed to the antLSDUDVLWLFGUXJ and can go on to establish in a host (refugia)
d
e
f
g

 

 

c Implementation of quarantine procedures
d
e
f
g

 

c Pasture management­ multispecies grazing, controlling forage height, rotational grazing, etc.
d
e
f
g
c Selection for parasite resistant animals
d
e
f
g

 
 

c Alternative techniques (copper wire particles or fungi, etc)
d
e
f
g

 

c Age specific treatment recommendations (for example, minimizing treatment of adult animals)
d
e
f
g

 

c Use of two or more antiparasitic drugs at the same time in individual animals
d
e
f
g

 

c Strategic deworming (treating when majority of parasites are in the animal and not in the environment)
d
e
f
g

 

c I have not implemented or recommended any management practices for parasite control
d
e
f
g

 

c Other (please specify)
d
e
f
g

 

 

Small Ruminants - 55

Detection and Management of Resistance ­ Small Ruminants

 

Have you changed the management practices you implement or recommend for parasite control in small ruminants in response to antiparasitic
drug resistance? Please choose one answer.
 

j No, because I have not experienced any resistance
k
l
m
n

 

j No, because changes have not been necessary
k
l
m
n

j Yes, in response to information about resistance
k
l
m
n

 
 

j Yes, in response to resistance that I have experienced
k
l
m
n

 

j Other (please specify)
k
l
m
n

 

 

Small Ruminants - 56

Continue Survey

 

If you would like to repeat the Treatment Decisions and Detection and Management of Resistance portions of the survey for a different animal
species or class, please choose one of the options below. Otherwise to continue to the final portion of the survey, please choose 'Continue with
survey'.
j Cattle
k
l
m
n

  Continue to Page 15
  Continue to Page 29

j Horses
k
l
m
n

j Continue with survey
k
l
m
n

  Continue to Page 58

 

Small Ruminants - 57

Ruminant and Equine Antiparasitic Drug Use and Antiparasitic Resistance Survey
Marketing and Labeling Information

 

Product labeling is one way to provide information about the indications and use of an antiparasitic drug. How helpful or unhelpful would you
find the following choices if added to an antiparasitic drug label?
Somewhat 

Neither helpful nor 

unhelpful

unhelpful

j
k
l
m
n

j
k
l
m
n

Warnings regarding antiparasitic drug resistance if warranted

j
k
l
m
n

Management recommendations to minimize the development of 

j
k
l
m
n

Very unhelpful
Recommendations for how to detect antiparasitic drug 

Somewhat helpful

Very helpful

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

resistance

antiparasitic drug resistance
Comment (if desired) 

 

Conclusion-58

Marketing and Labeling

 

Freedom of Information (FOI) Summaries are available electronically through http://www.fda.gov/AnimalVeterinary/Products/default.htm which
summarize the safety and effectiveness information submitted to support the approval of animal drugs.
Were you aware of the availability of FOI Summaries?
j Yes
k
l
m
n

 

 

j No
k
l
m
n

If yes, which parts of the FOI Summary do you find most useful? 

 

Conclusion-59

Marketing and Labeling

 

In your opinion, should approved combinations of antiparasitic drugs be available over­the­counter or by prescription­only in the United States?
Yes

No

Undecided

Over­the­counter

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Prescription­only

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Explanation, if desired 
5
6

 

Conclusion-60

Wrap Up

 

In your opinion, what are the roles/responsibilities, if any, of the following groups in managing the use of antiparasitic drugs to minimize the
development of antiparasitic drug resistance?
Veterinarians
Regulatory agencies
Academia/ Science
Producers/ Animal owners
Pharmaceutical companies
Producer groups and affiliated 
organizations
Is there any additional information you would like to convey that has not yet been covered in this questionnaire relative to antiparasitic drug
resistance and/or antiparasitic drugs?
5
6

 

End of Survey

Conclusion-61

Acknowledgment

 

Thank you for your interest in the FDA Center of Veterinary Medicine Food Animal Antiparasitic Drug Use and Antiparasitic Resistance Survey.
The FDA values your input but at this time we are restricting our collection to those with experience in equine, bovine and small ruminant species
in the United States. If you would like to share any comments or concerns that you have experienced regarding antiparasitic drug use or
antiparasitic resistance, please use the comment form below.
If you have any questions about the survey, please contact Janis Messenheimer, DVM at (240) 276­8348 or [email protected].
To exit the survey, please choose "Exit the survey"
 

j Exit the survey
k
l
m
n

Please comment if desired. 
5
6

 

Exclusion - 62


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